KUALA LUMPUR: Firefighter Muhammad Adib Mohd Kassim was suffering from serious lung injuries caused by blunt trauma when he arrived at the Subang Jaya Medical Centre (SJMC), the Coroner’s Court was told.
Dr M. Nanta Kumeran, the 12th witness, the emergency doctor who treated Adib at SJMC, said the medical team suspected that the 24-year-old had a punctured lung as well as fractures to bones on the right side of his ribcage.
“Based on our X-ray results, however, we found he was suffering from a lung contusion (bruising of, and not puncture to, the lung), and fractures to his second, third, fourth and fifth ribs.
“In the X-ray result, the lung usually will appear pitch black. However, in Adib’s case, there were white patches all over the lung, which meant there were abrasions in that area,” he said.
Questioned by deputy public prosecutor Zhafran Rahim Hamzah, Dr Nanta Kumeran said the injuries could have been caused by blunt force trauma.
He also said he had to perform resuscitation on Adib when the fireman arrived at the hospital as the latter’s blood pressure and vitals were low.
“When he arrived, I saw him gasping for air and unconscious while making incomprehensible sounds. His pulse was 145 beats per second (bps), blood pressure 85/46, and he only had 48 per cent of oxygen level in his blood,” he said, adding that the normal oxygen level was more than 95 per cent.
Dr Nanta Kumeran said he was unable to communicate with Adib as he had a low level of consciousness.
Zhafran: What did you do?
Dr Nanta Kumeran: I called cardiologist Dr Anand, anaesthetist Dr Zurina, and asked to send the patient to be X-rayed as I heard a cracking sound on the right side of his ribs (when he was moved). I suspect he suffered from pneumothorax.
Zhafran: What is pneumothorax?
Dr Nanta Kumeran: The presence of air or gas in the cavity between the lungs and the chest wall (pleural space), causing collapse of the lung.
Zhafran: What did Dr Zurina do?
Dr Nanta Kumeran: She examined the patient and decided to do intubation (the insertion of a tube into the trachea) to help him breath manually.
Zhafran: What did Dr Anand do?
Dr Nanta Kumeran: Dr Anand also assessed the patient and decided to put in a chest tube to increase oxygen levels and remove excess air in Adib’s pleural space. He also ordered a computerised tomography (CT) scan on Adib’s abdomen, head and chest.
Dr Nanta Kumeran said Adib’s abdomen, neck, face and scrotum were swollen due to subcutaneous emphysema (leaking of air below the skin).
Asked the source of the subcutaneous emphysema, he said air from the lung was leaking as it was badly injured.
Asked about bruising to Adib’s right arm and whether this was due to him being gripped, the doctor said the injury was more likely caused by blunt force trauma.
Zhafran: Were there any imprints or marks on Adib’s body?
Dr Nanta Kumeran: No prints... all bruises.
Zhafran: What were the nature of the injuries, especially on Adib’s right upper arm?
Dr Nanta Kumeran: I believe from major blunt force trauma.
Zhafran: Is that due to an impact or gripping?
Dr Nanta Kumeran: In my opinion it looked like impact.
Dr Nanta Kumeran said his objective was to increase Adib’s level of oxygen and blood pressure which he did after the chest tubing.
He said, after treating Adib for more than an hour, he went outside the emergency room to approach three Indian men who had brought Adib to hospital, to get a clearer picture of the situation.
“They told me they found Adib lying on the ground and did not know what actually happened to the fireman. They said they did not know whether Adib had fallen from the fire engine or had been beaten,” he said.
The inquest will continue tomorrow before coroner Rofiah Mohamad.
It was claimed that Adib died from severe injuries sustained after he was allegedly assaulted by rioters at the Sri Maha Mariamman temple in Subang Jaya on Nov 27.